Evidence-Based Research in Hand Surgery

描述(申请人提供)：本次K24续展申请将继续获取手外科领域的证据，重点是治疗桡骨远端骨折(DRF)，向学员传授循证实践和原则。首席调查员(PI)是一名卫生服务研究员，其兴趣包括循证医学、流行病学和结果研究。PI之前的研究集中在肌肉骨骼疾病上，如类风湿性关节炎和桡骨远端骨折(DRF)，特别是在老年人中。除了对DRF结果的持续研究外，这笔赠款还将包括一个指导计划，向越来越多的初级教员、外科住院医生、国际研究员和医学生教授循证医学和研究方法。该项目的目标是启动一项随机对照临床试验，以比较两种手部治疗方案对患有DRF的老年患者的疗效，DRF是影响这一不断增长的人口的最常见损伤。使用掌侧锁定钢板系统(VLP)切开复位内固定DRF的患者将接受完全监督手部治疗(FHT)或最小监督自我指导手部治疗(MHT)。这项研究的具体目的是(1)对接受VLP治疗的老年人DRFs进行随机对照试验，比较MHT和传统FHT，以及2)开发一个预测模型，以确定哪些患者将从FHT中受益。这项研究的数据将提供有关这一损伤的术后处理的重要信息，并确定切开复位和DRF内固定后功能结果的预测因素。此外，这项研究将提供证据，帮助医疗保健提供者为DRF患者提供最佳护理，并产生经济数据，以潜在地降低全国成本。这个K24奖项的主要焦点是应用这个项目 对学员进行循证医学、流行病学、统计学和研究方法方面的教育。整个应用程序(候选人、环境和研究)。包括候选人的近期和长期职业目标、研究职业发展计划的主要内容以及对研究项目的说明，如第一部分4.4.6所示。提供整个应用程序(候选人、环境和研究)的摘要。包括候选人的近期和长期职业目标、研究职业发展计划的主要内容以及对研究项目的说明，如第一部分4.4.6所示。抄送

DESCRIPTION (provided by applicant): This K24 renewal application will continue to derive evidence in the field of hand surgery by focusing on the treatment of distal radius fractures (DRF) to teach trainees evidence-based practice and principles. The principal investigator (PI) is a health services researcher whose interests include evidence-based medicine, epidemiology and outcomes research. The PI's previous research has concentrated on musculoskeletal diseases such as rheumatoid arthritis and distal radius fractures (DRF), particularly among the elderly. In addition to continuing research on DRF outcomes, this grant will incorporate a mentoring program to teach evidence-based medicine and research methodology to a growing number of junior faculty, surgery residents, international fellows and medical students. The goal of this project is to initiate a randomized-controlled clinical trial to compare outcomes of two hand therapy programs for elderly patients with DRF, which is the most common injury affecting this growing population. Patients treated with open reduction and internal fixation of DRFs using the volar locking plating system (VLPS) will receive fully-supervised hand therapy (FHT) or minimally supervised self-directed hand therapy (MHT). The specific aims of the study are (1) To conduct a randomized controlled trial comparing MHT versus traditional FHT for DRFs in the elderly treated with VLPS, and 2) To develop a predictor model to identify patients who will benefit from FHT. The data derived from this study will provide vital information about the postoperative management of this injury and define predictors of functional outcomes after open reduction and internal fixation of DRFs. Furthermore, this study will yield evidence to assist healthcare providers in giving the best care to DRF patients and generate economic data to potentially reduce costs nationally. The principal focus of this K24 award is to apply this project to educate trainees about evidence-based medicine, epidemiology, statistics and study methodology. entire application (candidate, environment, and research). Include the candidate's immediate and long-term career goals, key elements of the research career development plan, and a description of the research project, as indicated in Part I.4.4.6. Provide an abstract of th entire application (candidate, environment, and research). Include the candidate's immediate and long-term career goals, key elements of the research career development plan, and a description of the research project, as indicated in Part I.4.4.6. CC